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目的了解奥沙利铂联合5-氟尿嘧啶、亚叶酸钙联合同期放疗综合治疗中晚期食管癌的远期疗效。方法1996年10月~2000年6月对114例中晚期食管癌患者随机分为两组:A组(对照组)57例,单纯予放疗。B组(治疗组)57例,同期放疗外,予PCF方案化疗(国产奥沙利铂130g/m2静滴2小时,第1天,5-氟尿嘧啶300g/m2静滴1~3天;亚叶酸钙200g/m2静滴1~3天,21天为1周期,化疗4个周期,两组放疗均为直线加速器,经CT的定位后设胸部三野照射(常规分割)前野12cm×6cm,两后野12cm×5cm,照射总量为60~70Gy/6~7周。结果3年生存率B组33.71%(19/57)高于A组16.41%(9/57),P<0.05。4年生存率B组22.15%(13/57)高于A组8.72%(5/57),P<0.05。毒副反应为骨髓抑制,放射性食管炎,胃肠道反应肾损害。结论奥沙利铂联合5-氟尿嘧啶、亚叶酸钙化疗加放疗能提高中晚期食管癌的疗效,延长生存期。
Objective To investigate the long-term efficacy of oxaliplatin combined with 5-fluorouracil and leucovorin combined with concurrent radiotherapy in the treatment of advanced esophageal cancer. Methods From October 1996 to June 2000, 114 patients with advanced esophageal cancer were randomly divided into two groups: Group A (control group) 57 cases, treated with radiotherapy alone. 57 patients in group B (treatment group) received PCF regimen chemotherapy (oxaliplatin 130g / m2 intravenously for 2 hours on day 1, 300g / m2 intravenous drip for 1-3 days on day 1, leucovorin Calcium 200g / m2 intravenous infusion of 1 to 3 days, 21 days for a period of 4 cycles of chemotherapy, radiotherapy are linear accelerator in both groups, the location of the CT chest thoracic radiation (routine segmentation) anterior field 12cm × 6cm, Field 12cm × 5cm and total irradiation 60-70Gy / 6-7 weeks.Results The 3-year survival rate was 33.71% (19/57) in group B and 16.41% (9/57) in group A, P <0.05.5.4 years The survival rate was 22.15% (13/57) in group B, which was significantly higher than that in group A (8.72%, 5/57), P <0.05.The toxicities were myelosuppression, radiation esophagitis and gastrointestinal renal damage.Conclusion Oxaliplatin Combined with 5 - fluorouracil, leucovorin chemotherapy plus radiotherapy can improve the efficacy of advanced esophageal cancer and prolong survival.